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SPECT neuroimaging and neuropsychological functions in different stages of Parkinson’s disease

  • Anna Paschali
  • Lambros Messinis
  • Odysseas Kargiotis
  • Velissarios Lakiotis
  • Zinovia Kefalopoulou
  • Costantinos Constantoyannis
  • Panagiotis Papathanasopoulos
  • Pavlos Vassilakos
Original Article

Abstract

Purpose

The present study investigated differences and associations between cortical perfusion, nigrostriatal dopamine pathway and neuropsychological functions in different stages of Parkinson’s disease (PD).

Methods

We recruited 53 non-demented PD patients divided into four groups according to the Hoehn and Yahr (HY) staging system and 20 healthy controls who were used in the comparison of the neuropsychological findings. Each patient underwent two separate brain single photon emission computed tomography (SPECT) studies (perfusion and dopamine transporter binding) as well as neuropsychological evaluation. Perfusion images of each patient were quantified and compared with a normative database provided by the NeuroGam software manufacturers. Mean values obtained from the cortical areas and neuropsychological measures in the different groups were also compared by analysis of covariance (ANCOVA) controlling for disease duration and educational level.

Results

We found cognitive deficits especially in the late PD stages (HY 3, 4 and 5) compared to the early stages (HY 1 and 2) and associations between cognitive decrements and cortical perfusion deterioration mainly in the frontal and posterior cortical areas. Compared with controls, PD patients showed impairments of cognition and cerebral perfusion that increased with clinical severity. Furthermore, we found a significant correlation between the performance on the phonemic fluency task and regional cerebral blood flow (rCBF) in the left frontal lobe. Dopamine transporter binding in the left caudate nucleus significantly correlated with blood flow in the left dorsolateral prefrontal cortex (DLPFC), but not with measures of executive functions.

Conclusion

There are significant cognitive and perfusion deficits associated with PD progression, implying a multifactorial neurodegeneration process apart from dopamine depletion in the substantia nigra pars compacta (SNc).

Keywords

Parkinson’s disease Brain perfusion SPECT Dopamine transporter SPECT Cognitive functions 

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Anna Paschali
    • 1
  • Lambros Messinis
    • 2
  • Odysseas Kargiotis
    • 2
  • Velissarios Lakiotis
    • 1
  • Zinovia Kefalopoulou
    • 3
  • Costantinos Constantoyannis
    • 3
  • Panagiotis Papathanasopoulos
    • 2
  • Pavlos Vassilakos
    • 1
  1. 1.Department of Nuclear MedicineUniversity of Patras Medical SchoolPatrasGreece
  2. 2.Department of Neurology, Neuropsychology SectionUniversity of Patras Medical SchoolPatrasGreece
  3. 3.Department of NeurosurgeryUniversity of Patras Medical SchoolPatrasGreece

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